April Fools’ Day – 6 silly eye care myths you should know about

Photo Courtesy of jenschapter3 on Flickr

Photo Courtesy of jenschapter3 on Flickr

It is April Fools’ Day and to help ensure you don’t look foolish, I wanted to share a little eye information with you. There are a number of myths out there about your eyes and I wanted to quickly clear up some of the confusion. I hear a few of these myths every week with my patients, so here are a few of the most common:

  1. “Eye exercises can strengthen your eyes so you won’t need glasses.” While it is true you can make your eyes function better by doing eye exercises, for the majority of patients, glasses or contacts are needed to keep their vision consistently clear. The exception to this rule is that some children can benefit from eye exercises under the direction of an optometrist trained in vision therapy, which can help reduce a child’s need for glasses.
  2. “High pressure in your eyes means you have glaucoma.” Glaucoma is a very serious eye disease that can result in permanent vision loss. We know that having pressure beyond  a certain range significantly increases your risk of developing glaucoma, it does not mean you actually have glaucoma.
  3. “Contacts can slip behind the back of your eye and get struck in your brain.” Our body’s natural defense system ensures that this cannot happen. The conjunctiva is a tissue that covers the inner portions of your eyelids and the white of your eye. It is a continuous tissue that prevents anything from getting behind your eye, that includes contacts, eyelashes, or any other things that may get into your eye.
  4. “Wearing glasses makes your eyes weaker.” This common myth does not take into account that as your eyes age, your ability to see clearly without correction is reduced. Small prescriptions that did not require correction as child or young adult can present later in life as blur or visual discomfort requiring glasses.
  5. “If you can see clearly, you have healthy eyes.” Sadly, this is a common myth that keeps many people from getting their eyes checked on a regular basis. Comprehensive annual eye examinations with your doctor of optometry can help ensure that you have healthy eyes and detect serious vision-threatening or even life-threatening diseases well before they become a problem. Tumors, uncontrolled diabetes, strokes and other serious health problems can be caught during an eye exam with your optometrist. Regular exams with a doctor of optometry can help ensure clear vision and healthy eyes.
  6. “Eyes can actually pop out of your head.” This myth gets perpetuated by the many horror movies that show eyes being knocked out of a person’s head and rolling along the ground. Fortunately for us all, this does not happen. Your eyes are held in place by muscles that move your eye up, down, left and right. Additionally, you have a nerve that plugs into the back of your eye that can also hold it in place. Systemic health disease, such as thyroid eye disease, or compressive trauma can cause your eyes to protrude beyond your eyelids but they will never fall out of head like they do in the movies.

I hope shedding some light on the eye myths helped increase your knowledge and keep you from looking foolish.

 ~Ranjeet S. Bajwa, OD, FAAO
California Optometric Association
http://eyehelp.org
http://www.coavision.org

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You may have cataracts?

Courtesy of entirelysubjective on Flickr

Courtesy of entirelysubjective on Flickr

Cataracts are common

Not a day goes by in the office when I don’t tell a patient that he or she has a cataract, which is any kind of clouding in the crystalline lens of our eye. Some patients have heard of the term and understand that it’s a common occurrence as one ages. Other patients are terrified of the term and think it’s a disease that will make them blind. But the patients I relate to are the ones who hear the word cataract, and think “I’m old.”

Cataracts can affect your vision

If it helps, most cataracts develop over decades, from young adulthood onward. As early as 40 years old, we can start to notice the effects of this change over time. The crystalline lens in our eye, which is responsible for focusing light onto our retinas, begins to change shape and chemical structure over time. These changes result in more light scatter and dimming of vision. Usually, a patient will begin noticing glare from car headlights, double or ghost images around letters and lights or that night vision is not as clear or bright.

These are often initial symptoms and do not require treatment. As the cataracts continue to develop, patients’ eyeglass prescriptions may begin to change and they will also experience blurry or cloudy vision with worsening of the above symptoms. When they reach this point, which is about half of patients over the age of 65, cataract surgery may be indicated.

Cataract surgery – not as bad as you’d think

Cataract surgery is the most common surgery performed in the world. Nowadays, it can be a 15 minute out-patient procedure. The cataract is removed from the eye and replaced with an artificial lens implant, called an intraocular lens. With many advancements in this field, the lens implant can also have specialty optics which can correct for astigmatism or for both distance and reading.

What many don’t know is that cataract surgery is an optional procedure. A cataract is not malignant and does not always have to be removed. However, a patient’s vision will improve significantly with a successful cataract surgery. They will notice a much brighter and clearer environment. Some patients who have glaucoma or have a crowding of the internal structures of the eye would benefit from having cataract surgery.

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Photo courtesy of Community Eye Health on Flickr

Types of cataracts

There are many different forms of cataracts. In fact, I found a cataract in a 9-month old baby when his mom brought him in for a well-visit eye examination. In such a case where the eye is still developing, clouding of the lens can interfere with visual development and needs to be removed. Other congenital form of cataracts may simply be a cloudy spot on the lens which doesn’t interfere with vision. In this case, there is no need for cataract surgery.

Cataracts can also develop from trauma, use of certain medications and diabetes. Depending on the type, a cataract can slowly worsen over years, or change rapidly requiring surgical intervention within months. For patients whose vision is changing rapidly, I often like to follow them every few months to monitor for vision and cataract changes.

People often ask what can be done to prevent cataracts. Unfortunately, genetics plays a factor so if your parents required cataract surgery, you will most likely need one also. If you’re outdoors, wear a good quality pair of sunglasses that block UVA/UVB rays. This goes for kids as well since exposure to ultraviolet radiation is cumulative. If you’re outdoors for long periods of time, throw on a hat for added protection. Smoking has been shown to cause cataracts also, so limit your exposure to cigarette smoke. If you are currently being treated for diabetes or using steroid medications, be sure to see your internist regularly.

Why wait for your vision to blur? See your optometrist every year!

Most importantly, see your optometrist annually for an eye examination. They can check for cataracts but also determine if there are other factors that may be contributing to a reduction in your vision. It’s not just the lens that helps you to see but a whole network of related structures that work as a team to provide you with optimal vision.  If you require a new pair of glasses, always opt for an anti-glare coat on the lenses, which would further reduce disabling glare symptoms.

~Cindy P. Wang, OD, FAAO
http://eyehelp.org
http://www.coavision.org

 

Why 20/20 isn’t perfect-What is visual acuity?

Courtesy of riekhavoc (caughtup?) on Flickr

Courtesy of riekhavoc (caughtup?) on Flickr

Measuring normal vision

When patients come to see me, I need to have a way to compare how they see in relation to someone with normal vision.  So, like most eye doctors, I use a number system called Snellen visual acuity.  This measure of the clarity of vision uses black letters on a white background.  If you have ever had an eye examination, it is when the doctor asks you to read the letters on the chart that starts with a big “E”.  The letters are called optotypes and they have a very specific design that takes into account the size of the lines and the space between them.  While there are other types of visual acuity measurements, this is the most common.

20/20 isn’t perfect

The measure most people want to achieve with Snellen visual acuity is 20/20 vision.  While 20/20 is pretty darn good vision, in reality, 20/20 is not exceptional vision so much as it is more like the lowest possible visual acuity a person can have and be considered normal.  In fact, many people have the potential to see somewhere between 20/16 and 20/12 which means that they see even better than 20/20!

Paul B. (Halifax)

Paul B. (Halifax)

What do the numbers mean?

People also ask me to explain what the numbers mean.  As an example, take a person with 20/40 vision.  A person with 20/40 is at a disadvantage compared to a person with normal, 20/20 vision.  In fact, a person with 20/40 vision would have to stand 20 feet away from something that a person with normal vision can stand 40 feet away from and still see.

A number of factors like eye disease, the eye’s length and curvature, and the quality of connection between the eye and the processing centers in the brain come together to determine visual acuity.  Some factors, like nearsightedness, come with easy solutions like glasses.  Others, like macular degeneration, are much more complex and simple solutions like glasses only offer minimal improvement.  If a patient has very poor visual acuity, they may need magnifiers and telescopic lenses to help.

So,  the next time you go to the optometrist, give the 20/15 line a shot.  Good luck!

~David Ardaya, OD
California Optometric Association
http://eyehelp.org
http://www.coavision.org

Health care reform & vision coverage for your children

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Children’s vision now covered by most plans
If your child is covered by an individual or group health insurance plan in California, their annual eye exam and eye glasses are covered with no out-of-pocket cost until the child reaches age 19. This is required for health plans purchased through or outside Covered California.

Legal residents of California will be able to get health coverage through a new marketplace established by Covered California. Starting in 2014, there will be several new and expanded government programs, including Medi-Cal, that offer financial assistance to reduce the cost of health insurance.

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  1. Premium assistance — Federal help will be available to reduce the cost of an individual’s or family’s monthly health insurance payments.
  2. Cost-sharing assistance — Cost-sharing subsidies reduce the amount of health care expenses an individual or family has to pay at the time of medical care.
  3. Medi-Cal assistance — Starting in 2014, Medi-Cal will cover more people under age 65, including people with disabilities and those with incomes $15,856 or less a year for a single individual and $32,499 or less for a family of four. Medi-Cal is free for those who meet the requirements and is part of the changes included in the Patient Protection and Affordable Care Act (Affordable Care Act).

An online calculator at the Covered California website helps estimate how much it will cost to purchase health insurance in 2014 and the amount of financial assistance available to qualified individuals. In addition, by completing a Covered California application, an individual will learn whether he or she qualifies for financial assistance.

~Kristine Shultz, Government and External Affairs Director
California Optometric Association

Common myths about eyeglasses debunked!

Photo courtesy of Ben Andreas Harding on Flickr.

Photo courtesy of Ben Andreas Harding on Flickr.

As an optometrist, I often hear a variety of misconceptions about eyeglasses from my patients. Most concerns fall into a few broad categories with a few bizarre ones sprinkled in. I would like to take a brief moment to address some of the most common ones I hear:

  1. “Wearing glasses will make your eyes weaker.” This is probably the one myth I hear the most often and it is absolutely false. The biggest thing people forget to account for when they notice they are more reliant on their prescription glasses is that they are a bit older. As a person gets older, their ability to continue to see clearly without prescription glasses deteriorates. While this applies to everyone, it is most pronounced in my far-sighted patients in particular.
  2. “Not wearing your prescription glasses will make your eyes get worse.” This also is not true. Not wearing your glasses will not damage your eyes, but it can cause a significant amount of eyestrain. Extended viewing of computer monitors, smart phones, tablets or televisions without a proper prescription can lead to significant eyestrain and may cause you to discontinue viewing sooner than you planned.

    Photo Courtesy of TempusVolat on Flickr

    Photo Courtesy of TempusVolat on Flickr

  3. You can’t play sports with glasses on.” Not true! Glasses for sports can be made to protect your eyes and clear your vision at the same time. Protective lenses such as polycarbonate plastic can be put into sports goggles to allow a person to wear glasses when participating in sporting activities. Many patients prefer to wear contacts when they play sports, but it is a personal preference. Be sure to talk to your optometrist if you need specialty lenses for any of the activities you participate in.
  4. “Over the counter readers are just as good as prescription glasses.” This myth is not necessarily untrue. For a small group of patients, over the counter readers do work just as well as prescription reading glasses. The bad news is it’s an extremely small group of patients and those glasses work only when they are reading. Proper prescription glasses can correct each eye individually for the distance so both eyes are in focus and balanced. Once the eyes are balanced and working together, your optometrist can determine the proper power you need for your computer monitor or for reading materials. For the overwhelming majority of patients, there is a difference between the prescriptions between their eyes or some astigmatism in their correction that you cannot find in over the counter glasses.

I hope these answers help open your eyes to how prescription glasses can help you see clearly.

~Ranjeet S. Bajwa, OD, FAAO
California Optometric Association
http://www.coavision.org

“What if 1 and 2 look the same?!”

Courtesy of riekhavoc (caughtup?) on Flickr

Courtesy of riekhavoc (caughtup?) on Flickr

A common concern for some of my patients is if they don’t tell me the correct choice of lens, then their prescription for that year will be off and not work properly. This is not true. When an optometrist is switching between lenses (which we in “the business” call a refraction), we are fine-tuning a prescription using the patient’s input to find the lenses that are the most clear and comfortable.

Optometrists are trained to filter out incorrect answers from our patients as we double and sometimes triple check on your responses to make sure we have the right powers. Many optometrists do this by bracketing the lens choices presented to patients. Bracketing means we pick two lenses with a noticeable difference in powers and move towards the most clear of the two. By doing so, the lenses in 1 and 2 may end up being the same lens or lenses in choices 7 and 8, etc.

Additionally, when we bracket the lens choices our goal (or “end point”) is when the two choices look just about the same. So if your optometrist is checking your eyes and the two choices look about the same, tell them- that’s what we want to know.

Another thing that we as optometrists don’t want is to give you a glasses prescription that are too strong for you. That is why it is important for you to relax and try not to squint when your optometrist is checking your prescription. If you are constantly squinting when we try to refract you, then you are more likely to end up with glasses that only work well when you squint, but are too strong for you when you don’t.

Courtesy of Lyn Kelley Author on Flickr

Courtesy of Lyn Kelley Author on Flickr

Something I have found to help patients give better responses is remembering to blink often. Occasionally, a patient will get so fixated on telling me which lens looks better that they don’t blink as often as they normally would. This can cause your tear film on the surface of your eyes to start to break up and affect your ability to tell which lens looks better. Blinking often lets your eyelids put a smooth layer of tears over the front of your eyes. It is similar to polishing a lens, and a polished lens is always easier to see out of than a scratched lens.

Your optometrist can check on the health and structures of your eyes as well as check the function of your two eyes working together when you go in for your annual eye exam. The art of determining a person’s prescription is not easy, but an optometrist is trained to work with the responses of their patients. Don’t worry about getting it wrong! If you just remember some of the tips mentioned above, you can be sure your optometrist find your proper prescription.

~Ranjeet S. Bajwa OD
California Optometric Association
http://www.coavision.org

Are contact lenses dangerous?

Courtesy of wader on Flickr

Courtesy of wader on Flickr

The Benefits

Contact lenses are medical devices that millions of people wear safely every single day. Many people enjoy the freedom from glasses that contact lenses allow.

Contact lenses are also great options for:

  • Sports
  • Changing eye color
  • People who have irregularities to the front of the eye, cornea, or are not able to see with glasses.

Contact lenses make it possible to see and function in everyday life.

The Dangers

Contact lenses can be dangerous if they are abused.

Contact lenses are medical devices and can only be prescribed and dispensed by a licensed eye doctor. If they are sold without being evaluated on the eye by a doctor it can lead to:

  • Eye infections
  • Eye inflammation
  • Eye injuries

Proper care is key

Proper contact lens care and handling are important components of the contact lens fitting process. Contact lens solution used incorrectly or “topping off contact lens solution” (adding more without disposing of the current solution) can lead to multiple complications. It is important to use sterile contact lens solution and not tap water due to bacteria in water. Never, ever put contact lenses in your mouth or spit on them to try to clean them.

Courtesy of listentothemountains on Flickr

Courtesy of listentothemountains on Flickr

It is also important to replace contact lenses at the recommended frequency. For example, daily disposable contact lenses should be replaced each day. Contact lenses that are overused and abused can lead to serious problems.

Certain contact lenses are approved for sleeping or extended wear. However, if your contact lenses are not approved for extended wear, this can lead to complications on the cornea, or front of the eye.

If you are interested in contact lenses, schedule an appointment with a doctor of optometry today.

~Melissa Barnett, OD, FAAO